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PPROM - Preterm Premature Rupture Of the Membranes

I was 32 weeks pregnant when my waters broke and I was diagnosed with a condition called PPROM. In most cases when the waters break the baby is born within 72 hours. Our baby was born at 35 weeks 3 weeks after the membranes ruptured.

picture of fetal monitor

I will start of by giving you the facts. PPROM is a condition that happens before 37 weeks of pregnancy. The amniotic sac breaks and amniotic fluid gushes out or in some cases like my case it leaks out without any prior warning and without any signs of labour. This is commonly known at full term as your waters breaking.

The condition known as PROM (Premature Rupture of the Membranes) is the same as PPROM but after 37 weeks of pregnancy.

The onset of either PPROM or PROM can happen at any time during the pregnancy and the cause is often unknown. PPROM is diagnosed by a doctor doing an internal examination to look for amniotic fluid leaking from the cervix.

In majority of cases preterm labour usually starts pretty quickly after the onset of PPROM. I was told that I was likely to go into labour within 72 hours of the rupture. I did not go into labour but was induced at 35 weeks pregnant. It is common that if the baby has not been born by 35 weeks the Mother will be induced. In a small number of cases if the leak is high up in the amniotic sac it can heal so that preterm labour does not begin or subsides. Babies born prematurely after 24 weeks have grown enough to be able to survive outside your body. There are several risks associated with PPROM which turn an ordinary pregnancy into a high risk pregnancy but the Mother is usually monitored very closely.

Some of the risks are as follows:

The baby is likely to be born within a week of the rupture of the membranes. As mentioned above, this is not always the case as my membranes ruptured at 32 weeks and our baby was born at 35 weeks.

A major risk is the development of a serious infection of the placental tissues which is very dangerous for both the Mother and Baby. I was kept in hospital for a week as the doctors expected me to go into labour. After the initial week I was allowed to go home but had to rest and I was not allowed to leave the house except to go back to the hospital for my check ups. It was quite frustrating as I did not feel ill but had to rest. I was told that places like supermarkets and shopping centers were places that I could easily pick up a bug from.

Other complications that could occur include compression of the umbilical cord, cesarean birth, postpartum infection, early detachment of the placenta from the uterus.

The treatments:

A steroid injection is given to help speed up the development of the baby's lungs, this is administered at or before 34 weeks of pregnancy in two shots 24 hours apart. After 34 weeks of pregnancy the baby's lungs should be fully developed and it is therefore not necessary for the drug to be given. The drug takes approximately 48 hours to work and is said to have no side affect on the baby. I must say the injection was extremely painful. It was given to me in my thigh and I have never felt pain like it from an injection.

Antibiotics are usually given to help prevent or treat any infection that may have occurred or could occur in the amniotic fluid. I was given the antibiotics the day after I was diagnosed as having PPROM and the course was for 10 days.

The Mother will then have regular checks for fetal movement and fetal heart rate. Regular blood tests will be done to check for infections and scans to check the amniotic fluid levels and the general growth and well being of the baby. These checks are carried out until the Mother naturally goes into labour or if the pregnant woman has to be induced to bring on labour.

It was the scan that we had that made the doctors decide to induce me. Our son had not grown for two weeks. Although there was no sign of infection the doctors were concerned that the placenta was no longer working properly.

In majority of cases the Mother is taken into hospital soon after the leak has happened as most babies are born between 72 hours and a week of the membranes rupturing. Different hospitals have different practices. Some hospitals will decide that as soon as the baby's lungs have matured after the steroid drug has been administered they will deliver the baby. Other hospital's may try and see how long the Mother can keep the baby inside her and believe that every day that the baby is closer to its term date is a day extra that the baby has had to mature and grow. My hospital was one of those hospitals that preferred me to try and keep the baby in for as long as possible.

PPROM is responsible for 30% - 40% of all preterm deliveries.

Preterm Premature Rupture of Membranes relates to 1% - 2% of all pregnancies.

Things you can do once you have been diagnosed with PPROM:

Increase your fluid intake as this would help replenish the lost amniotic fluid. The more you drink the more the baby urinates.

Do not have sex

Do not bath with any bubble bath or similar products as this could cause irritations which could cause infections.

Try and rest as much as possible, this is to try and postpone labour.

If you have any concerns at all it is advisable to contact your midwife or the hospital immediately and to get checked over. Do not leave anything to chance if you have PPROM or suspect that you have PPROM, your pregnancy has gone from a normal pregnancy to a high risk pregnancy and all concerns should be investigated.

It is easy for me to say do not worry but the best advice I can give is to listen to the doctors and do what they say and any concerns to contact them immediately. Our son was born at 35 weeks and weighed 5lb 2 oz which is not a bad weight and every day he has gone from strength to strength.